Comparative Study of Kirschner Wire and Mini-Plate Fixation in Hand Fractures: Functional Outcomes and Postoperative...

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Metacarpal and phalangeal fractures are prevalent upper limb injuries impacting hand function.
• Surgical fixation with Kirschner wires (K-wires) and mini-plates is common, yet their comparative efficacy is debated.
• Key outcomes include functional recovery and postoperative pain management.

Purpose of the Study:

• To compare functional outcomes and analgesic needs for K-wire versus mini-plate fixation in metacarpal and phalangeal fractures.
• Evaluate differences in total active motion (TAM), pain scores, union time, and analgesic consumption.
• Provide evidence for optimal surgical technique selection.

Main Methods:

• Prospective comparative study of 50 adult patients with unstable metacarpal/phalangeal fractures.
• Two groups: K-wire fixation (n=25) and mini-plate fixation (n=25).
• Outcomes assessed: TAM, Visual Analog Scale (VAS) for pain, time to union, analgesic requirements at 1, 3, 6, and 12 months.

Main Results:

• Both K-wire and mini-plate groups showed improvement.
• K-wire fixation yielded significantly better TAM at 12 months (P < 0.001).
• Mini-plate fixation resulted in faster union and higher early postoperative analgesic requirements; complication rates were similar.

Conclusions:

• K-wire fixation provides superior long-term function and reduced analgesic needs.
• Mini-plate fixation offers enhanced early stability and quicker fracture union.
• Individualized implant selection based on patient factors and fracture characteristics is recommended.